Facility Evaluation Report
Capacity6
Census3
Date signed06/20/2024 03:03:00 PM
In conjunction to the complaint number 31-AS-20240612122942 Licensing Program Analyst (LPA) Mariana Agban conducted a case management- Deficiencies visit.
During the complaint investigation, it was confirmed that Licensee did not submit a Special Incident Report report for incident date 05/27/24 to CCL.
Exit interview conducted, citation issued and copy of this report delivered.
Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction